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OM Final 2019 > T spine, L spine, Mechanics DSA > Flashcards

T spine, L spine, Mechanics DSA Flashcards

1
Q

Thoracic Vertebra (T1-12)

A 
Body
-medium size
-heart shape
-costal facets
Spinous Process
-long
-slope posteroinferiorly
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2
Q

Lumbar Vertebra (L1-L5)

A 
Body
-large size
-kidney shaped
Spinous Process
-short, broad
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3
Q

Vertebral Unit

A

Two adjacent vertebrae and their associated intervertebral discs

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4
Q

Rule of 3’s

A

Refers to the location of the spinous process in relation to the transverse process in the thoracic spine

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5
Q

T1-3, T12

A

Spinous process located AT THE LEVEL of the corresponding transverse process

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6
Q

T4-6, T11

A

Spinous process located 1/2 A SEGMENT BELOW the corresponding transverse process

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7
Q

T7-9, T10

A

Spinous process located AT THE LEVEL of the transverse process of the vertebrae ONE BELOW

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8
Q

Superior Facet Orientation: Cervical

A

BUM

Backwards, Upward, Medial

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9
Q

Superior Facet Orientation: Thoracic

A

BUL

Backward, Upward, Lateral

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10
Q

Superior Facet Orientation: Lumbar

A

BM

Backward, Medial

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11
Q

Anterior Longitudinal Ligament

A

Strong, broad, fibrous band that covers and connects the anterolateral aspects of the vertebral bodies and IV discs

Limits extension

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12
Q

Posterior Longitudinal Ligament

A

Narrower, somewhat weaker band that runs within the vertebral canal along the posterior aspect of the vertebral bodies

Resists hyperflexion

Prevents posterior herniation of nucleus pulposus

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13
Q

Ligamentum Flava

A

Connect the laminae of adjacent vertebrae

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14
Q

Interspinous Ligaments

A

Connects adjoining spinous processes

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15
Q

Intertransverse Ligaments

A

Connects adjoining transverse processes

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16
Q

Rotatores

A

Rotatores Brevis: T1-T12 between transverse and spinous processes of adjacent vertebrae

Rotatores Longus: T1-T12 between transverse and spinous processes, skipping one vertebra

Bilateral: extend thoracic spine
Unilateral: rotate thoracic spine to opposite side

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17
Q

Multifidus

A

Origin: sacrum, ilium, mammillary processes of L-L5, transverse and articular facets

Insertion: superomedially to spinous processes, skipping two to four vertebrae

Innervation: spinal nerve

Bilateral: extends spine
Unilateral: flexes spine to same side, and rotates it to opposite side

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18
Q

Semispinalis

A

Capitis: C4-T7 to occipital bone

Cervicis: T1-T6 transverse processes to C2-C5 spinous processes

Thoracis: T6-T12 transverse processes to C6-T4 spinous processes

Innervation: spinal nerve

Bilateral: extends thoracic and cervical spines and head
Unilateral: bends head, cervical, and thoracic spines to same side, rotates to opposite side

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19
Q

Vertebral Motion: Flexion

A

S1-vertical, C7

40-90 degrees

20
Q

Vertebral Motion: Extension

A

S1-vertical, C7

20-45 degrees

21
Q

Vertebral Motion: Sidebending

A

S1-vertical, C7

15-30 degrees

22
Q

Vertebral Motion: Rotation

A

Central of head- acromion, ASIS

3-18 degrees

23
Q

Coupled Motion (Motion Principle #3)

A

Consistent association of a motion along or about one axis, with another motion about or along a 2nd axis

Motion cannot be produced without the associated motion occurring as well

24
Q

Linkage

A

Relationship of joint mechanics with surrounding structures

By linking structures together there is an increased ROM

Specific joint assessment requires joint isolation for accurate measurement and evaluation

Functional assessment of a joint may asses linkage

Normal vs. result of compensation

25
Q

Vertebral Nomenclature

A

Motion is always referenced to the movement of the anterior/superior surface of the vertebrae

Excessive motion or restriction is in reference to the vertebra ABOVE in a functional vertebral unit (Ie. excess motion of L2 is the motion of L2 on L3)

26
Q

Physiological Barriers

A

Limit of active motion

27
Q

Anatomic Barrier

A

Limit of motion imposed on anatomic structure

Limit of passive motion

28
Q

Elastic Barrier

A

Range between the physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption

29
Q

Restrictive Barrier

A

Functional limit within the anatomic range of motion

Abnormally diminishes the normal physiologic range

30
Q

Why does spinal somatic dysfunction matter?

A

Restrictions of motion in the spine

  • reduce efficiency
  • impair flow of fluids
  • alter nerve functions
  • create structural imbalance
31
Q

Fryette’s Principles

A

Harrison Fryette, DO

Described physiologic motion of the spine

Published in 1918

Developed two principles of spinal motion applicable to the thoracic and lumbar spine

32
Q

Who developed the 3rd principle and in what year?

A

C.R. Nelson, DO

1948

33
Q

Fryette: Type One Spinal Mechanics

A

Neutral Range:
Sidebending and Rotation = OPPOSITE

Rotation is towards the convexity of the spine

Tends to be a GROUP of vertebra

34
Q

Fryette: Type One Mnemonic

A 
TONGO
Type
One
Neutral
Group 
Opposite
35
Q

Fryette: Type Two Mechanics

A

Flexion or Extension:
Sidebending and Rotation = SAME direction

Rotation towards the concavity

Tends to be SINGLE vertebra

36
Q

Spinal Curvature

A

Cervical and Lumbar = Concave, Lordosis

Thoracic and Sacral = Convex, Kyphosis

37
Q

Fryette: Type Two Mnemonic

A 
TTOSS
Type 
Two 
Non-Neutral 
Single Segment
Same Direction
38
Q

Somatic Dysfunction Nomenclature: Type One

A

1) Locate vertebra or group (T1-3)
2) Indicate position (N- neutral)
3) Indicate sidebending (Sr- sidebent right; restricted to left sidebending)
4) Indicate rotation (Rl- rotated left; restricted to right rotation)

T1-3 NSrRl

39
Q

Somatic Dysfunction Nomenclature: Type Two

A

1) Locate vertebra or group (T9)
2) Indicate position (F-flexion; or E-extension)
3) Indicate sidebending (Sl- sidebent left; restricted to right sidebending)
4) Indicate rotation (Rl- rotated left; restricted to right rotation)

T9 FSlRl

40
Q

Fryette: 3rd Principle (Nelson’s Principle)

A

Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion

If motion is restricted in one direction, motion will also be restricted in other directions

If motion is improved in one direction, motion will improve in other directions

41
Q

Fryette’s Principles Summary:

A

Type 1 and Type 2 principles only pertain to thoracic and lumbar spine

Nelson’s principle is universal

42
Q

Testing Rotation SD

A

Push anterior on RIGHT transverse process > Vertebra rotates LEFT

Push anterior on LEFT transverse process > Vertebra rotates RIGHT

(Think bike handles)

43
Q

Equivalent Terms (Rotated Right SD)

A 
Posterior Transverse Process (PTP) on the right 
Right PTP
Rotated Right
Hard end feel with rotation to left
Hard end feel on the right (when applying anterior force to the right transverse process)
Restricted to rotation to the left
Will not rotate to the left
Lives in right rotation 
Held to the right
44
Q

Sidebending

A

Sidebent Right:
Resistance encountered when attempting to translate to the right
Ease of motion is felt with translation to the left

45
Q

Right Sidebending Dysfunction

A

Translation to the left induces right sidebending

Translation to the right induces left sidebending

46
Q

Spinal Landmarks

A

Spine of the scapula: T3 spinous process and transverse process

Inferior angle of the scapula: Spinous process of T7 and transverse process of T8

Iliac Crest: level of L4

OM Final 2019 (6 decks)

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